Effects of Transitional Care Model-Based Interventions for Stroke Patients and Caregivers on Caregivers' Competence and Patient Outcomes: Randomized Controlled Trial.

This study evaluated the effectiveness of the Transitional Care Model Stroke Turkey for stroke patients and caregivers as regards the competence of caregivers and patient outcomes. It is a parallel-group, assessor-blinded monocenter conducted with 126 participants in total (66 intervention included 33 stroke patients and 33 caregivers; 60 control groups included 30 stroke patients and 30 caregivers), between March and August 2018. The Transitional Care Model Stroke Turkey program lasts for 13 to 20 weeks. It includes a 12-week follow-up after discharge, a minimum of three hospital visits, one home visit, minimum 18 phone calls, and Web-based training. The intervention group exhibited better caregiver competence (13.48 ± 2.31), preparation for care (28.48 ± 4.74), and e-health literacy (34.42 ± 4.74) than the control group (respectively, 11.37 ± 2.48, 20.93 ± 7.10, 26.93 ± 8.53) ( P < .001). Emotional exhaustion and depersonalization increased in the control group, but remained the same in the intervention group. Personal accomplishment decreased in the intervention group, unlike in the control group. Within 12 weeks of discharge, five patients from the intervention group and seven patients from the control group were rehospitalized. There was no statistical difference between stroke patients in either group in terms of having previously used home healthcare services. The Transitional Care Model Stroke Turkey is a practical model for stroke patients transitioning from hospital to home.

Assessing the psycholinguistic and psychometric properties of the Turkish version of the Transition Questionnaire grounded on the Hospital-to-Home Transition Model.

PURPOSE: The aim of this study was to assess the psycholinguistic and psychometric properties of the Turkish version of the Transition Questionnaire, which is grounded on the Hospital-to-Home Transition Model. DESIGN AND METHODS: This cross-sectional methodological study was conducted with the participation of 380 parents in the neonatal intensive care clinic in a tertiary hospital between February 2020 and January 2021. A data assessment, number and percentage analysis, and language validity, content validity, and construct validity analyses were applied. In addition, a cluster analysis was performed on the sub-dimensions obtained from the questionnaire, and one-way analysis of variance was used to test the difference between the clusters. RESULTS: The content validity index was determined to be 0.89. It was determined that the sample size was adequate for the factor analysis (with a KMO value of 0.779 and Bartlett's test of sphericity value of χ2(276)=4026.181; p<0.05). As a result of the exploratory factor analysis, 12 items were omitted from the questionnaire. Fit indices of the new three-factor questionnaire structure that was formed upon removal of the items were evaluated by confirmatory factor analysis (χ2/df=4.783, RMSEA = 0.076, GFI = 0.776, AGFI = 0.726, CFI = 0.707, SRMR = 0.097). The reliability coefficient was found to be 0.871-0.716 for the sub-dimensions of the questionnaire and 0.795 for the overall questionnaire. CONCLUSIONS: It was determined that the Turkish version of the Transition Questionnaire is valid and reliable for making post-discharge evaluations of parents with preterm infants in Turkish society.

Effect of Telehealth Interventions on Blood Pressure Control: A Meta-analysis.

The aim of this study was to find out the effects of telehealth interventions on blood pressure control by conducting a meta-analysis. Six databases were used. The literature review covered the period between December 1, 2020, and January 26, 2021. The meta-analysis was conducted by comprehensive Meta-Analysis Software version 2.2. Categorical variables were analyzed by odds ratios at a confidence interval of 95%. In data formatting and analysis, independent groups (sample size, P value); independent groups (mean, SD); Cohen's d, SE; and paired groups (N, P value) were used. The bias risk was assessed based on the Revised Cochrane Risk-of-Bias Tool for Randomized Trials. Total sample size including 22 studies was 11 120. It was determined that interventions performed through telehealth applications had a significant effect on blood pressure control (odds ratio = -0.14; 95% confidence interval = -0.20 to -0.08; P < .001). In telehealth applications, blood pressure values decreased more when the application was performed through a Web site (-0.31; 95% confidence interval = -0.49 to -0.13), duration of the intervention was 12 months or shorter (-0.18; 95% confidence interval = -0.28 to -0.010), stroke developed in case of hypertension (-0.31, 95% confidence interval = -0.76 to 0.12), and the study was conducted in the Far East countries (-0.24; 95% confidence interval = 0.40 to -0.07). Interventions with telehealth applications are effective in blood pressure management. PROSPERO ID: CRD42021228536.

ChatGPT's potential to support home care for patients in the early period after orthopedic interventions and enhance public health.

OBJECTIVES: This study presents the first investigation into the potential of ChatGPT to provide medical consultation for patients undergoing orthopedic interventions, with the primary objective of evaluating ChatGPT's effectiveness in supporting patient self-management during the essential early recovery phase at home. MATERIALS AND METHODS: Seven scenarios, representative of common situations in orthopedics and traumatology, were presented to ChatGPT version 4.0 to obtain advice. These scenarios and ChatGPT̓s responses were then evaluated by 68 expert orthopedists (67 males, 1 female; mean age: 37.9±5.9 years; range, 30 to 59 years), 40 of whom had at least four years of orthopedic experience, while 28 were associate or full professors. Expert orthopedists used a rubric on a scale of 1 to 5 to evaluate ChatGPT's advice based on accuracy, applicability, comprehensiveness, and clarity. Those who gave ChatGPT a score of 4 or higher considered its performance as above average or excellent. RESULTS: In all scenarios, the median evaluation scores were at least 4 across accuracy, applicability, comprehensiveness, and communication. As for mean scores, accuracy was the highest-rated dimension at 4.2±0.8, while mean comprehensiveness was slightly lower at 3.9±0.8. Orthopedist characteristics, such as academic title and prior use of ChatGPT, did not influence their evaluation (all p>0.05). Across all scenarios, ChatGPT demonstrated an accuracy of 79.8%, with applicability at 75.2%, comprehensiveness at 70.6%, and a 75.6% rating for communication clarity. CONCLUSION: This study emphasizes ChatGPT̓s strengths in accuracy and applicability for home care after orthopedic intervention but underscores a need for improved comprehensiveness. This focused evaluation not only sheds light on ChatGPT̓s potential in specialized medical advice but also suggests its potential to play a broader role in the advancement of public health.

Effect of Transitional Care Model-Based Interventions for Patients with Stroke and Their Caregivers on Increasing Caregiver Competence and Patient Outcomes: A Study Protocol for a Randomized Controlled Trial.

AIM: This is a study protocol designed to evaluate the effect of transitional care model based interventions for patients with stroke and their caregivers on the caregivers' perceived competency, their preparedness for caregiving, increasing their electronic health literacy, reducing burnout, the rate of patients' hospital readmissions, and the frequency of pressure injuries. METHOD: The study protocol was planned as a randomized controlled trial with parallel arms. The study will include 70 patients with stroke and their caregivers. Multiple interventions (TEMpEST-Transitional Care Model Stroke Turkey), including at least 3 face-to-face interviews at the hospital, distance education via web, and telephone communications for 3 months, and 1 home visit within 7 days of discharge will be applied to the study group. The control arm will receive routine care. RESULTS: Findings will give after then when completed the study protocol. CONCLUSION: This study will evaluate the feasibility of interventions TEMpEST and its effect on patients with stroke and their caregivers. TRIAL REGISTRATION: The trial was registered with the ClinicalTrials.gov protocol registration and results system (PRS) (ClinicalTrials.gov reference NCT03708835).